#4901 THE EFFECT OF CHRONIC KIDNEY DISEASE IN CONTRAST-ENHANCED ULTRASONOGRAPHY WITH ARRIVAL TIME PARAMETRIC IMAGING

Abstract

Abstract Background and Aims CEUS is a reliable method to diagnose ischemic renal pathologies such as infarction, identify renal abscesses, discriminate between renal tumors and anatomical variants, describe complex cyst lesions, and monitor non-surgical renal lesions. Few studies explore the relationship between CEUS and the diagnosis or progression of CKD. The aim of this study was to evaluate the relationship between contrast-enhanced ultrasonography with arrival time parametric imaging (CEUS-PAT) and CKD. Method We prospectively evaluated 64 subjects (37 liver cirrhosis patients and 27 healthy volunteers) using CEUS-PAT to detect if the presence of CKD influences the arrival time of the contrast in the kidney. CKD was defined according to KDIGO 2021 guidelines. Ultrasonography was performed using the LOGIQ E9 (GE Healthcare, Chalfont St.Giles-UK) system, probe C1-6. CEUS was performed on each subject using SonoVue (Bracco SpA, Milan, Italy) as a contrast agent (1/2 of a vial). A 2.5 mL contrast substance followed by a 5 mL normal saline solution was infused in the cubital vein. A ratio between the arrival time of the substance in the kidney and liver was calculated. Subjects were in fasting conditions for at least 12 h. Laboratory data were extracted from the patient's GP file. The study was conducted between January -December 2018. All patients provided their informed consent for the procedures. Results The study included 64 subjects, mean age of 58.98 ± 8.90 years, predominantly male gender (56.3%). Of the 64 patients, 13 (20.3%) had chronic kidney disease. All patients with chronic kidney disease had liver cirrhosis. When comparing the two groups, with and without CKD, there was a significant difference between the ratio of the arrival time of the contrast agent into the kidney and liver, 0.85 ± 0.09 vs 0.65 ± 0.19, p = 0.0005. The factors associated with kidney disease were liver steatosis (p<0.0001), age over 60 years (p = 0.01) and low albumin (p<0.0001). Conclusion Our study indicated that the presence of CKD influences the contrast agent arrival time in the kidney. Further studies are needed to establish the predictive significance of CEUS-PAT data in CKD patients.